Poster #61 - Moderating effect of age on treatment gains following modified Constraint Induced Movement Therapy (mCIMT) in children with hemiplegia

• In Event: Poster Session 12

Abstract

Background/Objectives: Modified constraint-induced movement therapy (mCIMT) is an evidence-based treatment approach that uses principles of forced use of the affected side through constraint of the relatively unaffected upper extremity to promote arm use and hand function in children with hemiplegia. This motor learning approach leverages the neuroplasticity of the developing brain and therefore there is a push towards early intervention using the mCIMT approach in the hope of producing larger gains in function and upper extremity motor control compared to use of mCIMT at later ages. The present study analyzes retrospective longitudinal data collected over multiple years from children participating in a mCIMT-based summer camp to assess the moderating effect of age on the magnitude of improvement in arm function in children with hemiplegia
Study Participants: The poster will analyze retrospective data collected from 11 children with hemiplegia who participated in the summer camp across multiple years. Children had developed hemiplegia due to a variety of causes including cerebral palsy, infantile stroke, and hydrocephalus were included. Children participated in the camp following medical clearance from their physician.
Materials & Methods: The annual held summer camp lasted for 3 weeks, 5 days/week for 6 hours/day. During their time at the camp, children wore a cast on their unaffected/strong side and were encouraged to use their affected hand for all activities including feeding and using the restroom. Each child worked with a one-on-one aide during the camp. Camp activities included gross and fine motor games based on different themes that challenged children’s reach, grasp, manipulation, and release skills in a variety of contexts. Exemplar activities included ball activities, scooter board activities, sport-based activities like bowling, baseball, golf, etc., art-craft and building activities, sensory activities, videogames, musical activities, as well as functional training with a variety of supplies. Therapists at camp assessed changes in children’s motor function on the affected side using a 11-item custom-designed fine motor test that assessed reach, grasp, in-hand manipulation, and release skills. We will report change scores calculated by assessing difference in total scores on the fine motor test between the first and last day of camp across multiple years. We will further compare change scores from children across multiple years and assess the relationship between age and magnitude of improvement in motor function in children with hemiplegia. We will also explore the relationship between impairment severity and baseline motor performance on magnitude of improvement across multiple years.
Expected Results: We are presently analyzing data collected from children across multiple years. Our preliminary data suggest that children demonstrate greater improvements in performance at a younger age compared to as they get older.
Conclusions/Significance: Findings from this study have implications for initiating evidence-based early interventions to maximize functional gains in children with hemiplegia.

Authors

• Cindy Jackson
  Presenting Author

• Justina Courgi

• Dev Patel

• Vaishnavi Sandeep Shahane, University of Connecticut

• Sudha M Srinivasan, University of Connecticut